Project Summary Alzheimer?s disease (AD) is the most common form of dementia in the U.S., which is estimated to affect 5.7 million individuals in 2018. World-wide, it is estimated that 53 million individuals are living with Alzheimer?s disease and related dementias (ADRD), and the costs associated with caring for these individuals are estimated to be $818 billion. Neuropsychiatric symptoms (NPS) such as depression, agitation are common in patients with ADRD, and contribute to caregiver burden. NPS can be exacerbated by age-related hearing loss which is prevalent in nearly two-thirds of adults with dementia; however, traditional hearing services are often expensive and difficult to access for patients. The HEARS (Hearing Equality through Accessible Research & Solutions) intervention is a novel, theory-driven intervention, currently undergoing evaluation in a randomized controlled trial (R33DC015062) that may be a promising approach to addressing hearing loss and improving communication among persons with dementia. We now propose adapting the HEARS intervention to older adults with ADRD and their caregivers and pilot testing the feasibility, acceptability, and preliminary efficacy of an adapted intervention through a one-month pilot study. Building upon the HEARS audiologist-community health worker (CHW) model, this adaption will be delivered by a speech-language pathologist (SLP), which provides a potentially scalable and sustainable model responsive to the needs of older adults with ADRD. Aim 1 To adapt the HEARS hearing care intervention for older adults with ADRD through a user-centered needs assessment. Aim 2 To assess a community-delivered hearing care intervention adapted for older adults with ADRD, which will be composed of two sub-Aims. Aim 2a To pilot test the adapted HEARS intervention protocol via an open study (N=3-5) and refine the intervention based on early-stage implementation challenges and Aim 2b To assess the feasibility, acceptability, and preliminary efficacy of an adapted, community-delivered hearing care intervention through an NIH Stage 1b pilot study (N=15-20). The results from this pilot study will enable development of effective interventions for reducing the burden of dementia on patients and caregivers, which is a critical public health priority. Importantly, this proposed intervention has the potential to be scalable in the community as the home intervention delivered by speech- language pathologists (SLP) would be reimbursable under current Medicare codes.